Georgia Medicaid Provider Portal
Do you want to learn more about the Georgia Medicaid Provider Portal? We provide 24/7 simple access to our patients’ confidential health information over a secure internet gateway.
Georgia Medicaid Provider Portal
The Georgia Health Information Network (GHIN) is linked to the Georgia Medicaid Management Information System (GAMMIS) (GaHIN).
Authorized practitioners can do searches in the clinical viewer inside GAMMIS to find health information on specific Medicaid patients and access records listed in GaHIN.
The Provider Portal makes it simple for providers to communicate directly with WellCare about health care services. The free Provider Portal has the following features:
1. Information about co-pays and member eligibility that can be confirmed.
2. Requesting authorizations and checking status.
3. Use of PaySpan Health’s Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) (ERA).
4. Check the status of your submitted claims and your inquiries.
5. Online training and attestations are both possible.
How to Login to Georgia Medicaid Provider Portal
1. Visit Georgia Medicaid Provider Portal login website at https://www.mmis.georgia.gov/
2. Enter your username and password.
3. Click on sign-in or login.
4. You should be logged in successfully to Georgia Medicaid Provider Portal.
Unable to Login to Georgia Medicaid Provider Portal?
Are you unable to login to Georgia Medicaid Provider Portal? If so, you can do:
1. If you are having trouble logging in to https://www.mmis.georgia.gov, you should first check to see if your internet connection is live and operational.
Make sure you are accurately typing the login and/or password if that has already been verified. Use the password preview feature if it’s available on the website so you can double-check your entry.
2. Make sure the Capital Letters is not on, particularly if no password character or letter calls for it.
3. Make sure you are not using a VPN because some websites dislike it and will not allow you to login or access their portal if you are.
4. You might need to use the forgotten password option if all the aforementioned steps are successful but you still cannot connect to the Georgia Medicaid Provider Portal at https://www.mmis.georgia.gov/.
5. If the forgotten password function is ineffective, kindly get in touch with the site administrator for more help.
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Register for the Provider Portal
Users can be divided into two categories: sub-accounts and administrator users. In their profession or department, administrative users are to manage other website users (sub-accounts).
Create a New Account
Administrative users can register by visiting our provider website: georgia.wellcare.com/login/provider.
You will need the following to register:
1. WellCare-issued Provider ID number (in your welcome packet or on your Explanation of Payment).
2. Primary address ZIP code (the ZIP code submitted on your credentialing packet).
3. Tax Identification Number (TIN).
Complete the registration form by submitting your:
1. Provider ID.
2. ZIP code.
3. TIN.
Then give us information about your company and its users. The completion of a profile and acceptance of the HIPAA Terms and Conditions will be required of you. The next steps involve choosing a username and a security question and response.
The page for confirmation will appear. After registering, you will get an email with a temporary password within 24 hours. To use the website and generate a new password, log in using this password (within 30 days).
Be sure to keep your username and password for future reference.
Verifying Member Eligibility
1. You can search, view, save and print member-specific WellCare eligibility and enrollment information using the Provider Portal.
2. Log in at georgia.wellcare.com/login/provider.
3. Click the Eligibility tab.
4. Enter the Member ID number.
5. Click the Show Eligibility Co-pay button.
If you don’t have the Member ID on hand, you may use the Lookup Member tool on the WellCare provider website.
In addition, you may also validate eligibility and claim status through one of our Real-Time vendors. Please refer to the Real-Time Services section of this guide for more information.
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Via Provider Portal
Registered providers may log in, click the Authorizations tab, and then select Authorization Request.
Your phone and fax numbers should be provided for authorizations. A maximum of 10 clinical files may be attached.
You can enter pertinent clinical data into the text box to be added.
Until a final disposition has been decided, your requests might not be available in the Provider Portal enquiry. Because of this, you might get our fax response before viewing the decision online.
Via Fax
Fill out the proper notification or authorisation form according to the care required. Visit www.wellcare.com/en/Georgia/Providers/Medicaid/Forms to access the forms online.
Send the completed form, along with any necessary supporting documents, via fax to the number provided on the QRG.
Via Telephone
1. Emergent or Urgent Authorizations Only.
2. Urgent or Emergent Authorization Requests shall be made by telephone. Only when submitting an urgent request would substantially risk the member’s life or health may it be considered an emergency.
3. A decision on expedited permission requests will be made within 24 hours. To get an expedited authorization, call Provider Services at the number provided on the QRG.
How Long does it take to get a Medicaid Decision in Georgia?
Within 45 to 60 days of submitting your application, Medicaid eligibility will be confirmed. Any Particular Situations? On the same day that you apply, you can get a Medicaid certification form if you are pregnant and qualified.
What does Medicaid Cover?
Services include inpatient and outpatient hospital care, doctor services, laboratory and x-ray services, and home health care services are among the benefits that must be provided.
Prescription medications, care management, physical therapy, and occupational therapy are among the optional perks.
What Age are you Eligible for Medicaid?
If you are elderly (65 years of age or older), blind, or crippled and have little means, apply. If you are terminally ill and want hospice care, submit an application.
If you are elderly, blind, or disabled, if you live in a nursing home, if you have little resources, apply.
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